Diabetes Education Week – 2012 Update

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By Terry Orr

I am a Type-2 Diabetic – non-insulin and have been for nearly twenty years and I am still learning more and more about this disease and complications from diabetes. Today’s article focuses on two primary areas – Managing Diabetes and good references/links for excellent education information and support.

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Managing Diabetes - It’s not easy, but it’s worth it.

The National Diabetes Education Program (NDEP) website provides a wealth of excellent information on diabetes.  Diabetes Education Materials for People with Diabetes and their Families:

• 4 Steps to Control Your Diabetes - For Life;
• Know Your Blood Sugar Numbers;
• Help a Loved One with Diabetes; and
• “A Guide to Changing Habits.”

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Step 1: Learn about diabetes.

Diabetes means that your blood glucose (blood sugar) is too high. There are two main types of diabetes.

• Type 1 diabetes - the body does not make insulin. Insulin helps the body use glucose from food for energy. People with type 1 need to take insulin every day.
• Type 2 diabetes - the body does not make or use insulin well. People with type 2 often need to take pills or insulin. Type 2 is the most common form of diabetes.
• Gestational (jes-TAY-shon-al) diabetes - occurs in some women when they become pregnant. It raises her future risk of developing diabetes, mostly type 2. It may raise her child's risk of being overweight and developing type 2 diabetes.

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Step 2: Know your diabetes ABCs.

Talk to your health care team about how to manage your A1C, Blood pressure, and Cholesterol. This can help lower your chances of having a heart attack, stroke, or other diabetes problems. Here's what the ABCs of diabetes stand for:

A for the A1C test (A-one-C).

• It shows what your blood glucose has been over the last three months. The A1C goal for many people is below 7. High blood glucose can harm your heart and blood vessels, kidneys, feet, and eyes.

B for Blood pressure.

• The goal for most people with diabetes is below 130/80.
• High blood pressure makes your heart work too hard. It can cause heart attack, stroke, and kidney disease.

C for Cholesterol (ko-LES-ter-ol).

• The LDL goal for people with diabetes is below 100.
• The HDL goal for men with diabetes is above 40.
• The HDL goal for women with diabetes is about 50.

LDL or “bad” cholesterol can build up and clog your blood vessels. It can cause a heart attack or a stroke. HDL or “good” cholesterol helps remove cholesterol from your blood vessels.

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Step 3: Manage your diabetes.

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team to reach your ABC target. Use this self-care plan.

• Follow your diabetes meal plan. If you do not have one, ask your health care team to help you develop a meal plan.
• Eat healthy foods such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese.
• Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it.
• Eat foods that have less fat and salt.
• Eat foods with more fiber such as whole grain cereals, breads, crackers, rice, or pasta.
• Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more.
• Stay at a healthy weight by using your meal plan and moving more.
• Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.
• Learn to cope with stress. Stress can raise your blood glucose. While it is hard to remove stress from your life, you can learn to handle it. NDEP's Diabetes HealthSense provides online access to resources that support people with diabetes in making changes to live well.
• Stop smoking. Ask for help to quit. Call 1-800-QUITNOW (1-800-784-8669)
• Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects.
• Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away.
• Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums
• Check your blood glucose. You may want to test it one or more times a day. Use the card at the back of this booklet to keep a record of your blood glucose numbers. Be sure to show it to your health care team.
• Check your blood pressure if your doctor advises.
• Report any changes in your eyesight to your health care team.

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Step 4: Get routine care.

See your health care team at least twice a year to find and treat any problems early.

At each visit be sure you have a:

• Blood pressure check
• Foot check
• Weight check
• Review of your self-care plan shown in Step 3

Two times each year have an:

• A1C test - it may be checked more often if it is over 7

Once each year be sure you have a:

• Cholesterol test
• Triglyceride (try-GLISS-er-ide) test - a type of blood fat
• Complete foot exam
• Dental exam to check teeth and gums - tell your dentist you have diabetes
• Dilated eye exam to check for eye problems
• Flu shot
• Urine and a blood test to check for kidney problems

At least once get a:

• Pneumonia (nu-mo-nya) shot
• Hepatitis B shot

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For those of us who have smartphones – I strongly recommend getting on of the many diabetes apps.  They come in all sorts of sizes, shapes, colors, and capabilities!  I have been using Diabetes Buddy on my iPhone for the past year or so – good app – but I am still looking for one that suits my specific needs.  Every couple of months, I begin my research looking for “that app” which may satisfy my needs. One feature that you should insist on is the ability to email those results to y our medial team.  Some automatically do so monthly – nice feature and many doctors appreciate getting the email and enter into your medical record.

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References and Links:

• http://ndep.nih.gov/partners-community-organization/campaigns/CydflManagingDiabetes.aspx
• http://www.cdc.gov/DIABETES/ndep/
• http://diabetesandmetabolism.com/
• http://www.galenmedical.com/www/docs/127.44/diabetes-education-chattanooga-tennessee
• http://www.nlm.nih.gov/medlineplus/ency/article/003996.htm